利格列汀治疗2型糖尿病效果及其预测因素分析

Effect of linagliptin on type 2 diabetes mellitus and its predictive factors

目的探讨利格列汀治疗2型糖尿病的效果及疗效的预测因素。方法选取2018年9月—2020年6月收治的142例2型糖尿病患者为研究对象,所有受试者均接受利格列汀治疗,治疗后根据疗效将患者分为显效组和无效组,并采用多因素Logistic回归分析利格列汀治疗2型糖尿病效果的预测因素,另纳入同期接受利格列汀治疗的84例2型糖尿病患者验证该模型的预测效能。结果利格列汀治疗2型糖尿病的总有效率为51.41%(73/142)。多因素Logistic回归分析显示,基线糖化血红蛋白较低(OR=10.568)、空腹血糖较低(OR=1.453)、体质量指数(BMI)较低(OR=1.307)、2型糖尿病病程较短(OR=2.536)是利格列汀疗效的预测因素,列线图显示基于这些预测因素建立的预测模型的C-index为0.852,校正曲线显示列线图模型预测可能性绝对误差为0.011,验证模型的ROC曲线显示AUC为0.843。结论基线糖化血红蛋白较低、空腹血糖较低、BMI较低、2型糖尿病病程较短是影响利格列汀治疗2型糖尿病效果的预测因素。

Objective To explore the therapeutic effect of linagliptin on type 2 diabetes and its predictive factors.Methods A total of 142 type 2 diabetes patients who were admitted from September 2018 to June 2020 were selected as research subjects and administered with linagliptin.According to the therapeutic effects,the patients were divided into two groups:an effective group and an ineffective group.The predictive factors of the effect of linagliptin in the treatment of type 2 diabetes were analyzed by multivariate logistic regression.In addition,84 type 2 diabetes patients who received linagliptin treatment during the same period were included to verify the predictive performance of the model.Results The total effective rate of linagliptin in the treatment of type 2 diabetes was 51.41%(73/142).Multivariate logistic regression analysis showed that low baseline glycosylated hemoglobin(OR=10.568),low fasting blood glucose(OR=1.453),low body mass index(BMI)(OR=1.307),and short course of type 2 diabetes(OR=2.536)were the predictive factors of linagliptin.The nomogram showed that the C-index of the prediction model based on these prediction factors was 0.852.The calibration curve showed that the absolute error of the prediction possibility of the nomogram model was 0.011,and the ROC curve of the validation model showed that its AUC was 0.843.Conclusions Low baseline glycated hemoglobin,low fasting blood glucose,low BMI,and short course of diabetes mellitus are the predictive factors that affect the therapeutic effect of gliglitazone on type 2 diabetes.